THE adage HIV/AIDS does not choose its victims has never rung so true up until now.

More housewives than sex workers tested positive for HIV in 2006.

In that same year, 36 per cent of those infected were youths between 13 and 29 years old.

Shocking revelations, but not when the figures are dissected and the reasons behind them revealed.

Malaysians in general are well aware of HIV preventive methods - eight out of 10 correctly named condom use - but knowledge doesn't translate into practice.

Some studies rate condom use at 20 per cent while others 80.

Dr Soraya Aziz, a consultant to the United Nations Development Programme's project on HIV/AIDS & Islam, says she's taking the 80 per cent figure with a pinch of salt.

"From talking to people, we get the impression that Malaysian men are quite resistant to using the condom."

And public input for her study reveals that many don't even know how to put a condom on.

"A lot of people say to me, 'Yeah, we know what a condom is, but actually how do you use it?' This is especially true of the younger people."

Prevention of HIV/AIDS through sexual intercourse is as easy as ABC - both literally and figuratively - abstinence, being faithful to one's partner, and condom use.

Condoms do not guarantee a 100 per cent safety net, says condom exporter Clinton Ang, but it is the safest method to prevent sexually transmitted infections and the most cost effective.

The male condom comes in just one size, doesn't break easily if used with water-based lubricants, and is so strong that it is recommended by the British Special Forces to be included into the survival kit because it can hold up to 18 litres of water.

Ang says non-governmental organisations working on HIV prevention use 50 to 70 per cent of their funds on condom procurement alone at any one prevention programme.

In containing the infection spread, it makes sense that people argue abstinence and being faithful are effective methods, says Dr Soraya.

"But if you tell people only about abstinence and don't give them an option - if they want to have sex, they won't know how to practise safe sex. So abstinence is not good enough on its own.

"That's why we have to talk about the A, B and C."

The reality, in Malaysia at least, is people do not talk about condom at all.

Condom myths, such as that they break easily and reduce sexual pleasure, have made their rounds more than once.

But the biggest misconception locally, even if it's never said out loud, is condoms are associated with people who are promiscuous and immoral.

Many forget that the first condoms were invented to prevent pregnancies. It started off with family planning.

A case lost in translation, perhaps, but no amount of information can right this negative perception if the issues surrounding sex remain a taboo subject.

Cultural sensitivities make talking about condoms doubly hard because one has to pass through the first layer of sensitivity on sex in general, before overcoming the second barrier on condoms in order to get the message on safe sex across.

Dr Soraya says Malaysians need to speak about health related issues as they are because sex is part of life, and especially when lives of young people are at risk due to ignorance of HIV and other STIs.

Although religions prohibit pre- and extra-marital sex, it shouldn't stop religious scholars from talking about condom use within marital relations because there's a growing number of wives being infected by their husbands, she adds.

"For marginalised groups like sex workers and transsexuals, we have to find other channels. But we have a door open here, why not use that open door to talk about condoms?"

From the UNDP project, Dr Soraya found that many religious professionals don't promote condom use, but they accept medical practitioners stepping in to do so.

"We cannot expect the religious authorities to speak the same language as the NGOs and medical professionals."

The female condom is a great option in helping overcome the gender power imbalances with regards to condom use, says Dr Soraya.

It is currently not available in Malaysia, but will soon be made so as a United Kingdom-based female condom manufacturer has just set up a plant in Balakong and will introduce it to the local market.

It is pricey (RM13 in other countries) but the female condom takes away the need to have the man's co-operation in using a barrier method for protection.

"It will put the power back into women's hands."

It's a short-term measure in the fight for gender equality.

Leading by example

LAST week, the Iranian government installed five condom and syringe vending machines in Teheran as part of its fight against the spread of AIDS and hepatitis among drug users.

The harm reduction campaign might raise eyebrows but scores big in the HIV/AIDS prevention milestone.

Many countries have employed various ways in bringing down the number of infection, but Senegal is probably the best example how a Muslim-majority country was able to tackle the HIV/AIDS epidemic, says Dr Soraya Aziz.

As its neighbouring countries in sub Saharan Africa struggle with booming HIV/AIDS rates, Senegal has managed to keep its number of infection down to less than one per cent of the population.

The decisive factor was that Muslim religious leaders were brought onto the agenda of HIV/AIDS prevention very early on, says Dr Soraya.

The country's leaders consulted very early on with the religious leaders, who talked openly about safe sex and reproductive health issues nationwide.

"It's possible, even in a Muslim-majority country, to do such a thing."

In Bangladesh, religious authorities and imams undergo training programmes, which touch on HIV/AIDS, gender equality and reproductive health, before they assume their role.

Because of the cultural sensitivities surrounding sex and reproductive health issues, it also makes sense to overcome the gender barrier by having women communicate with their peers, says Dr Soraya.

Mosques in China have not only male imams, but also female counterparts who reach out to the women in the congregation.

"If we need to talk about such difficult topics, perhaps female religious leaders would be more appropriate in conveying the message to the female part of the congregation."

Malaysia, too, has good practices, says Dr Soraya.

For example, the Federal Territory Islamic Affairs Department (JAWI) and PT Foundation have been holding religious classes for the transsexual community for the last four years.

"That may not translate to talking about practising safe sex and condom use, but when you have interfaces between the religious authorities and marginalised groups, you begin to have a better understanding of the needs of regular people in dealing with the issues of HIV/AIDS."

This story was first published in New Straits Times on May 3, 2008.